Basic counseling skills module: Theoretical approaches to counselling
Basic Counselling Skills 1. Attending Behaviour 2. Closed and Open-Ended Questions 3. Paraphrase 4. Summary 5. Reflection 1) 'Attending Behaviour' ' ' Orienting oneself physically and psychological Encourages the other person to talk Lets the client know you’re listening Conveys empathy What Does Attending Behaviour Look Like? ' ' a) SHOVLER (Or SOLER – the underlined): ' ' S': Face the other '''S'quarely ''' H: H'''ead nods '''O: Adopt an O'''pen Posture '''V: V'''erbal Following '''E: Sp'e'''ech '''L': L'ean toward the other '''E: '''Make '''E'ye Contact '''R: Be Relatively R'''elaxed '''b) Listening: ' ' Listening is the most important skill in counselling. It is the process of ‘hearing’ the other person. Three aspects of listening; i) 'Linguistic:' actual words, phrases and metaphors used to convey feelings. ii) 'Paralinguistic:' not words themselves but timing, accent, volume, pitch, etc. iii) 'Non-verbal:' ‘body language’ or facial expression, use of gestures, body position and movement, proximity or touch in relation to the counsellor All these express the internal state of the counselee and can be ‘listened’ to by the attentive counsellor. 2) 'Four types of Counselling Interventions' ' ' i) 'Open-Ended Questions' Questions that clients cannot easily answer with “Yes,”, “No,” or one- or two-word responses “Tell me about your family while you were growing up” “Why is that important to you?” How did you feel when that happened?” “What did you do when she said that?” “What are your reasons for saying that?” Purposes of Open-Ended Questions: ' ' To begin an interview To encourage client elaboration To elicit specific examples To motivate clients to communicate ii) ''Closed-Ended Questions''' ' ' Questions that the other can easily answer with a “Yes,” “No,” or one- or two-word responses “Are you going to have the test done?” “Did you drink before you got into the car?” “Do you drink often?” “Do you exercise?” “Do you like your job?” Purposes of Closed-Ended Questions: ' ' To obtain specific information To identify parameters of a problem or issue To narrow the topic of discussion To interrupt an over-talkative client Closed vs. Open-Ended Question ' ' Examples C: Are you scared? O: How do you feel? C: Are you concerned about what you will do if the test results are positive? O: What do you think you might do if the test results are positive? C: Is your relationship with your husband a good one? O: Tell me about your relationship with your husband. iii) ''Reflection:' ' ' Reflection is the echoing back of the last few words that the client has spoken. It is widely used in Rogerian counselling. e.g.: ''Counselee: We moved to Bangalore from gulf at the beginning of last year but none of us really settled down. My wife never did like living in such a large city. I found it difficult to get a job…. Coun''sellor: You found it difficult to get a job… Counselee: Well, it was difficult to start with, any way. I suppose I didn’t really try hard enough … ''Counsellor: ''You didn’t really try hard enough … ''(more later-below) '' '' iv) 'Challenging:' ' ' Though challenging and confronting are not associated with counselling, there are times they are appropriate and even necessary. Counselee: ''There is no one in this organization that I can talk to at all ''Counsellor: No one? Counselee: I have always been a failure, never been any good at anything. Counsellor: ''Always? '''3) 'Paraphrasing ' ' The counsellor rephrases the content of the client’s message Example: Ø Client: “I know it doesn’t help my depression to sit around or stay in bed all day.” Ø Counsellor: “It sounds like you know you should avoid staying in bed or sitting around all day to help your depression.” Purposes of Paraphrasing ' ' To convey that you are understanding him/her Help the client by simplifying, focusing and crystallizing what they said May encourage the client to elaborate Provide a check on the accuracy of your perceptions When to use it ' '''When you have an hypothesis about what’s going on with the client ****When the client is in a decision making conflict ****When the client has presented a lot of material and you feel confused '''Steps in Paraphrasing' ' ' Client, a 40-year-old woman: “How can I tell my husband I want a divorce? He’ll think I’m crazy. I guess I’m just afraid to tell him.” Steps a) Recall the message and restate it to yourself covertly b) Identify the content part of the message c) Wants divorce, but hasn’t told husband because he will think she’s crazy d) Select an appropriate beginning: E.g., “It sounds like,” “You think,” “I hear you saying,” e) Translate the key content into your own words: Want a divorce= break off, split; E.g., “It sounds like you haven’t found a way to tell your husband you want to end the relationship because of his possible reaction. Is that right?” f) Confirm the accuracy of the paraphrase Practice: 'Get into triads/dyads and do the following paraphrases together ' ''' '''4) 'Summary' ' ' v A collection of two or more paraphrases or reflections that condenses the client’s messages or the session v Covers more material v Covers a longer period of client’s discussion Purposes of a Summary ' ' To tie together multiple elements of client messages To identify a common theme or pattern To interrupt excessive rambling To start a session To end a session To pace a session To review progress To serve as a transition when changing topics Steps in a Summary ' ' Example- Client, a young girl Ø At the beginning of the session: “I don’t understand why my parents can’t live together anymore. I’m not blaming anybody, but it just feels very confusing to me.” in a low, soft voice with lowered, moist eyes Ø Near the middle of the same session: “I wish they could keep it together. I guess I feel like they can’t because they fight about me so much. Maybe I’m the reason they don’t want to live together anymore.” ' ' a) Recall key content and affect messages Ø Key content: wants parents to stay together Ø Key affect: feels sad, upset, responsible b) Identify patterns or themes Ø She is the one who is responsible for her parents’ break-up c) Use an appropriate sentence stem and verbalize the summarization response Ø e.g., “I sense,” or “You are feeling” d) Summarize Ø e.g., “Earlier today you indicated you didn’t feel like blaming anyone for what’s happening to your parents. Now I’m sensing that you are feeling like you are responsible for their break-up e) Assess the effectiveness of your summarization Practice: '''A 30-year-old man who has been blaming himself for his wife’s unhappiness: I really feel guilty about marrying her in the first place. It wasn’t really for love. It was just a convenient thing to do. I feel like I’ve messed up her life really badly. I also feel obliged to her. in low, soft voice tone with lowered eyes '''Practice: '''A 27-year-old woman who has continually focused on her relationships with men and her needs for excitement and stability: Ø First session: I’ve been dating lots and lots of men for the last few years. Most of them have been married. That’s great because there are no demands on me. eyes, facial animation, high-pitched voice Ø Fourth session: It doesn’t feel so good anymore. It’s not so much fun. Now I guess I miss having some commitment and stability in my life. voice, lowered eyes '''5) 'Reflection' ' ' A verbal response to client emotion Example Client: “So many things are going on right now: another hectic semester has started, my dog’s sick, and my mom’s ill too. I find myself running around trying to take care of everything. I’m not sure I can take it anymore.” Counsellor: “You’re feeling pretty overwhelmed by all the things that are going on right now.” ' ' Purposes of a Reflection ' ' Helps clients: Feel understood Express more feelings Manage feelings Discriminate among various feelings Steps of a Reflection Ø Client, a 50-year-old steelworker now laid off: “Now look, what can I do? I’ve been laid off over a year. I’ve got no money, no job, and a family to take care of. It’s also clear to me that my mind and skills are just wasting away. in a loud, critical voice, staring at the ceiling, brow furrowed, eyes squinting a. Listen closely and observe behaviour Ø Watch nonverbal behaviour Ø Verbally reflect the feelings back to the client b. Identify the feeling category c. Identify the intensity d. Match the feeling and intensity of a word e. Feed back to the client f. Add content using the form Ø “You feel ___ , because _____.” g. Check for accuracy ' ' '''Practice: '''Get into your triads/dyads and do the following paraphrases together Category:Financial economics Category:Divorce Category:Marriage